The prevalance of binge eating disorder and associated psychiatric and substance use disorders in a student population in Kenya – towards a public health approach

Abstract

Introduction Kenya in particular and Africa in general lack data on Binge Eating Disorder (BED). The overarching objective of this study is to fill that gap. Kenyans may not be aware that BED exists when a “very good” appetite is considered a sign of good health, especially if food is available either at home, in fast food shops or when communally eating together, a very common cultural practice. On the other hand where there is relatively insufficient food, it is not expected that one could be having a problem of eating too much. Method We administered the following tools and measurements to 9742 participants (high school, college and university students): 1) Researcher designed socio-demographic and economic indicator questionnaire; 2) An instrument documenting DSM-IV diagnostic criteria for BED and its various symptoms; 3) An instrument to determine DSM-IV psychiatric disorders and substance abuse;4) An instrument measuring high risk for psychosis ,affectivity and stress; 5) A WHO designed instrument measuring the severity of substance abuse for specific substances. We used descriptive and inferential analysis to determine the prevalence and association of the different variables. Independent predictors of BED were generated from a generalized linear model (p<0.05). Results We found a prevalence of 3.2% of BED and a wide range of prevalence for BED and BED related symptoms (8.1% to 19%). The least prevalent was "To prevent weight gain from eating binge did you force yourself to vomit, or used laxatives?”. The most common was "Did you often go on eating binges (eating a very large amount of food very quickly over a short period of time)." Major depression, obsessive compulsive disorder, panic disorder, agoraphobia, generalized anxiety disorder ,a positive stress screen and drug abuse were independent predictors of BED (p<0.05). Conclusion Our findings on the prevalence of BED and significant associations with various psychiatric disorders and substance use disorders are similar to those obtained in High Income Countries (HIC) using similar large-scale samples in non-clinical populations. Our findings suggest the need fora public health approach to enhance awareness of BED and to promote health-seeking behaviour towards management of BED.

Worldwide prevalence of DSM-5 eating disorders among young people

“…In Brazil, the prevalence of binge eating disorder was 1.4%, that of bulimia nervosa was 0.7%, but the prevalence of recurrent binge eating was 6.2% [41]. In Kenya, the prevalence of binge eating disorder was estimated to be 3.2% among women and men [42]. However, in another African setting, in rural Burkina Faso, clinical eating disorders were quite rare.…”

Burden and risk factors of mental and substance use disorders among adolescents and young adults in Kenya: results from the Global Burden of Disease Study 2019

“… 27 , 28 However there are also reports on rise of eating disorders in youth due to changes in quality of life, and urban westernized life style impacts on parent-child relationships and parenting. 29 There is evidence that HIV cases in highly emaciated youth may be presenting themselves with HIV associated anorexia that can also be classified under eating disorders.…”

Clinical Factors Associated with Binge-Eating Episodes or Purging Behaviors in Patients Affected by Eating Disorders: A Cross-Sectional Study

“…Extensive evidence in the literature supports the association between EDs and substance use disorders (SUDs) [ 23 ], even among adolescents and college students [ 59 , 60 ]. Particularly, the connection between binge eating and SUDs has been extensively studied and demonstrated in various countries [ 61 , 62 , 63 ], suggesting that these two disorders may share underlying neurobiological mechanisms regardless of food availability. Importantly, the impact of SUDs on mortality rates in EDs appears to be additive compared to control subjects without SUDs [ 64 ], and the comorbidity between EDs and SUDs increases the risk for somatic diseases beyond the effects of each disorder independently [ 65 ].…”